Decentralized Local Health Services in Tanzania

Research Report

Decentralized Local Health Services in Tanzania

Are Health Resources Reaching Primary Health Facilities, or Are They Getting Stuck at the District Level?


This study analyzes local health finances in Tanzania by considering the extent to which public health resources in Tanzania flow from the district government level to primary health facilities, or whether these resources get stuck at the district level. Our analysis of health expenditures in six rural Local Government Authorities suggests that less than half of local health funding reaches the front-line dispensaries that provide the vast majority of local health services. The structure of the local health system appears to favor top-down interventions and control, rather than empowering local facilities to improve local health outcomes.

To reuse content from Urban Institute, visit, search for the publications, choose from a list of licenses, and complete the transaction.